Abstract
Background
Most studies reporting the outcomes of laparoscopic ovarian prolapsed hernia operations with large sample sizes are based on intracorporeal closure, while studies on extraperitoneal closure have limited sample sizes. We proactively used the single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) technique and obtained favorable outcomes, which we report in this paper.
Methods
We retrospectively reviewed patients who had undergone laparoscopic surgery for inguinal hernia at our institution. They were retrospectively classified into two groups based on the pre- or intraoperative diagnosis of hernia with a prolapsed ovary, namely the prolapse group and the non-prolapse group, respectively. The data were statistically analyzed and p < 0.05 was considered statistically significant.
Results
A total of 771 subjects underwent SILPEC during the study period, including 400 girls. Among them, 63 girls were diagnosed with an ovarian prolapsed hernia. SILPEC was successfully performed through a single port in all cases, with a single exception, in whom the forceps was inserted directly through the right lower quadrant to pull up the ovary. The duration of surgery in the prolapse group was not higher than that in the non-prolapse group. During the SILPEC surgery, the ovaries were successfully reverted into the abdominal cavity by external compression of the inguinal area alone in 38 of the 63 patients. In the remaining 25 cases, the ovaries were reverted into the abdominal cavity by external compression of the inguinal area and traction of the round ligament with forceps. None of these cases failed to return to the ovaries.
Conclusion
Our study results indicate that SILPEC may be performed safely for the treatment of ovarian prolapsed inguinal hernia. Since the ovary and fallopian tube are close to the internal inguinal ring due to the short round ligament, the procedure requires careful suturing with traction of the round ligament.
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References
Wang YJ, Zhang QL, Chen L, Lin Y, Zhang JQ, Wu DM, Huang WH, Zhou CM (2019) Laparoscopic percutaneous extraperitoneal internal ring closure for pediatric inguinal hernia: 1,142 cases. J Laparoendosc Adv Surg Tech A 29:845–851
Wang D, Yang P, Yang L, Jin S, Yang P, Chen Q, Tang X (2020) Comparison of laparoscopic percutaneous extraperitoneal closure and laparoscopic intracorporeal suture in pediatric hernia repair. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2020.11.022
Fazeli A, Davari HA, Hosseinpour M (2020) A modified approach for single-port laparoscopic repair of inguinal hernias in children. Adv Biomed Res 9:63
Shaughnessy MP, Maassel NL, Yung N, Solomon DG, Cowles RA (2021) Laparoscopy is increasingly used for pediatric inguinal hernia repair. J Pediatr Surg. https://doi.org/10.1016/j.jpedsurg.2021.01.032
Dreuning KM, Barendsen RW, van Trotsenburg AP, Twisk JW, Sleeboom C, van Heurn LE, Derikx JP (2020) Inguinal hernia in girls: a retrospective analysis of over 1000 patients. J Pediatr Surg 55:1908–1913
Takehara H, Hanaoka J, Arakawa Y (2009) Laparoscopic strategy for inguinal ovarian hernias in children: when to operate for irreducible ovary. J Laparoendosc Adv Surg Tech A 19(Suppl 1):S129–S131
Goldstein IR, Potts WJ (1958) Inguinal hernia in female infants and children. Ann Surg 148:819–822
Ishii T, Yonekura T, Yamauchi K, Kamiyama M, Morishita Y, Kimura K, Kogata S (2016) Laparoscopic repair of sliding inguinal hernia in female children. Pediatr Surg Int 32:895–899
Uchida H, Kawashima H, Goto C, Sato K, Yoshida M, Takazawa S, Iwanaka T (2010) Inguinal hernia repair in children using single-incision laparoscopic-assisted percutaneous extraperitoneal closure. J Pediatr Surg 45:2386–2389
Lee SR (2021) Ovarian incarceration and torsion in single-ovary versus multiple-reproductive organ prolapse in female inguinal hernia: A retrospective study of 510 infants who underwent laparoscopic hernia repair. J Laparoendosc Adv Surg Tech A 31:110–116
Esposito C, Gargiulo F, Farina A, Del Conte F, Cortese G, Servillo G, Escolino M (2019) Laparoscopic treatment of inguinal ovarian hernia in female infants and children: standardizing the technique. J Laparoendosc Adv Surg Tech A 29:568–572
Kuyama H, Uemura S, Yoshida A, Yamamoto M (2019) Close relationship between the short round ligament and the ovarian prolapsed inguinal hernia in female infants. Pediatr Surg Int 35:625–629
Amano H, Tanaka Y, Kawashima H, Deie K, Fujiogi M, Suzuki K, Morita K, Iwanaka T, Uchida H (2017) Comparison of single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) and open repair for pediatric inguinal hernia: a single-center retrospective cohort study of 2028 cases. Surg Endosc 31:4988–4995
Schier F, Montupet P, Esposito C (2002) Laparoscopic inguinal herniorrhaphy in children: a three-center experience with 933 repairs. J Pediatr Surg 37:395–397
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The authors would like to thank Editage (www.editage.jp) for the English language review.
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Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Hizuru Amano, Masamune Okamoto, Aitaro Takimoto, Akihiro Yasui, Yoichi Nakagawa, Akinari Hinoki and Hiroo Uchida declares that they have no conflict of interest.
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Shirota, C., Tainaka, T., Sumida, W. et al. Single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) for inguinal hernia with prolapsed ovary. Surg Endosc 36, 4328–4332 (2022). https://doi.org/10.1007/s00464-021-08777-4
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DOI: https://doi.org/10.1007/s00464-021-08777-4